What Is The Neurospinal Service?

The Neurospinal Service (N.S.S.) provides rehabilitation for people with spinal cord injuries, multiple sclerosis and other neurological conditions. The Neurospinal Service’s interdisciplinary team is dedicated to bringing patients to their full potential, with the ultimate goal of returning patients to family or community living.

Who Are The Members Of The Neurospinal Service?

The interdisciplinary team includes:

Chaplain

Family Physicians

Orthotists

Physiatrists

Psychologists/Neuropsychologists

Rehabilitation Nurses

Respiratory Therapists

Speech Language Pathologists

Ward Clerk

Clinical Dietitians

Occupational Therapists

Pharmacist

Physical Therapists

Recreation Therapists

Rehabilitation Engineers

Social Workers

Vocational Rehabilitation Counsellors

Who Is Eligible For The Neurospinal Service?

Patients must be 18 years of age or older

Patients who live in Eastern Ontario or Western Quebec, or those who do not have access to therapy in their area

Patients who typically have one of the following diagnoses:

Spinal cord injury:

Quadriplegia (complete or incomplete)

Paraplegia (complete or incomplete)

Central cord syndrome

Cauda equina syndrome

Spinal tumours/ meningiomas

Conus Medullaris syndrome

Brown-Séquard Syndrome

Spina Bifida

Neurological conditions:

Multiple Sclerosis (MS)

Guillain Barre Syndrome

Amyotrophic Lateral Sclerosis (ALS) / Motor Neuron Disease

How Do Patients Enter The Neurospinal Service?

Patients must obtain a referral from their acute care physician or family physician.

Patients are assessed in the clinic or in the acute care facility by a Neurospinal Service physiatrist to identify rehabilitation issues.

What Services Does The Neurospinal Team Provide To Patients?

The inpatient services are patient-goal oriented and assist patients in goal selection upon admission.

Inpatient beds are available to patients requiring intensive rehabilitation who have one or more of the following:

Recent injury

Flare-up of an existing condition

Significant physical deconditioning

Decreased mobility

Unsafe or inaccessible home environment

Complex psychosocial needs

Difficulty coping at home

Inadequate community support

Equipment needs

Patients are expected to experience some degree of neurological and functional recovery before returning home. With patients who are more severely impaired, the focus becomes education for the patient and their significant others to maximize independence and community reintegration.

The length of inpatient rehabilitation can vary from a few weeks to several months, depending on the medical condition and the particular needs of the patient

Outpatient Services:

Inpatient Follow-up: Some inpatients may not meet all of their rehabilitation goals by the time of discharge. Following discussion with the appropriate team member, outpatient visits may be scheduled to follow through on mutually agreed upon goals.

Outpatient Clinics: Specialized multi-disciplinary clinics such as the Seating Clinic and the ALS Clinic are available to suitable outpatients. Patients living in the community with a spinal cord injury or Multiple Sclerosis are seen by the physiatrist and nurse clinician. Referrals to other interdisciplinary team members are made as appropriate.

Outreach Services: Nursing consultation services are offered through the Nurse Practitioner. Clients living in the community can contact the Nurse Practitioner directly, either at The Rehabilitation Centre or at its affiliated community health care centre, Pinecrest-Queensway Health and Community Centre.

Community Consultation: Team members consult with family and health care workers to provide information aimed to optimize patient functioning in the home and community environments. Consultation may include liaison with, or referral to, community groups and services, such as:

Community Care Access Centre (CCAC)

Centre local des services communautaires (CLSC)

Funding agencies

Private facilities and nursing homes

The In Community

Independent Living Centre

The Multiple Sclerosis Society

Canadian Paraplegic Association

VHA Health and Home Support

How Can Family Members Become Involved?

Families are encouraged to provide ongoing input and feedback.

A Family Conference is held for patients usually within the first four weeks of admission. At this conference, the patient and family meet with the team to discuss goals and issues. These may include the patient’s medical situation, functional level, progress to date, prognosis, equipment needs, discharge plans and follow-up after discharge. In addition, a discharge conference is held if required prior to the patient returning home.

A Family Day may be scheduled in addition to the family conference once the patient has established a routine. Patients may wish to invite their families or significant others to meet the clinical team and follow them through a typical therapy day. The family will observe the patient in therapy and gain an understanding of his/her functional level, therapy techniques and goals. This provides the families with an opportunity to ask clinicians questions, obtain education and plan for the patient’s discharge.

Family Education Sessions are offered to family members of inpatients. These sessions provide information on rehabilitation topics that are of interest to family members.

What Are Some Unique Aspects Of The Neurospinal Service?

Patients with respiratory muscle weaknesses are referred to the respirologist and the respiratory therapist for optimal non-invasive airway management assisting with lung hygiene and ventilation where indicated. You can find more information on this topic by visiting the section on Respiratory Service.

The Neurospinal Service offers group education sessions to patients. These sessions provide information on areas of interest such as community resources, skin care and peer support. Patients have the opportunity to meet informally after the sessions and browse the Resource Centre.

A peer support program is offered to patients in conjunction with the Canadian Paraplegic Association and the MS Society. The program arranges for patients to meet with others who have had similar spinal cord injuries or neuromuscular diseases.

As a Multiple Sclerosis Best Practice initiative, a multidisciplinary committee has been evaluating research literature with the goal to improve outpatient services for patients with multiple sclerosis.

The Neurospinal Service treats patients from Baffin Island as a part of The Ottawa Hospital Services Network Inc. (OHSNI).